What should I tell my health care provider before I take this medicine?

They need to know if you have any of these conditions:

cancer, such as breast, uterine, or other cancer

heart disease

history of blood clots

history of stroke

history of vaginal bleeding

liver disease

premenopausal

smoke tobacco

an unusual or allergic reaction to ospemifene, other medicines, foods, dyes, or preservatives

pregnant or trying to get pregnant

breast-feeding

What should I watch for while using this medicine?

Visit your health care professional for regular checks on your progress. You will need a regular breast and pelvic exam and Pap smear while on this medicine. You should also discuss the need for regular mammograms with your health care professional, and follow his or her guidelines for these tests. Also, periodically discuss the need to continue taking this medicine. Taking this medicine for long periods of time may increase your risk for serious side effects.

This medicine can increase the risk of developing a condition (endometrial hyperplasia) that may lead to cancer of the lining of the uterus. Taking progestins, another hormone drug, with this medicine lowers the risk of developing this condition. Therefore, if your uterus has not been removed (by a hysterectomy), your doctor may prescribe a progestin for you to take together with your estrogen. You should know, however, that taking estrogens with progestins may have additional health risks. You should discuss the use of estrogens and progestins with your health care professional to determine the benefits and risks for you.

This medicine can rarely cause blood clots. You should avoid long periods of bed rest while taking this medicine. If you are going to have surgery, tell your doctor or health care professional that you are taking this medicine. This medicine should be stopped at least 4-6 weeks before surgery. After surgery, it should be restarted only after you are walking again. It should not be restarted while you still need long periods of bed rest.

You should not smoke while taking this medicine. Smoking may also increase your risk of blood clots. Smoking can also decrease the effects of this medicine.

This medicine does not prevent hot flashes. It may cause hot flashes in some patients.

If you have any reason to think you are pregnant; stop taking this medicine at once and contact your doctor or health care professional.